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EDUCATIONAL RESPONSES

TO HIV AND AIDS FOR


REFUGEES AND INTERNALLY
DISPLACED PERSONS:
DISCUSSION PAPER FOR DECISIONMAKERS
EDUCATIONAL RESPONSES
TO HIV AND AIDS FOR
REFUGEES AND INTERNALLY
DISPLACED PERSONS:
DISCUSSION PAPER FOR DECISIONMAKERS

January 2007
TA B L E OF CONTENTS

Acknowledgements 4
Acronyms 5
Overview 6
Current Situation of Refugees and IDPs 8
Conflict, Displacement and HIV 9
Special Characteristics and Protection Risks of Refugees and IDPs 10
Poverty and dependency on aid 11
Abuse and trauma 11
Compounded protection risks 11
Obstacles to schooling and learning 11

Education for Refugees and IDP’s 12


The right to education for all 13
Education for girls and women 14
Quality education in emergency settings 15

Key Components of Educational Responses to HIV and AIDS for Refugees and IDPs 16
1. Policy, management and systems 18
2. Quality education, including cross-cutting principles 19
3. Content, curriculum and learning materials 21
4. Educator training and support 23
5. Approaches and entry points 24

Conclusions and Recommendations 26


End Notes 28
References 29
ACKNOWLEDGEMENTS

This discussion paper is the result of collaboration between the United Nations
Educational, Scientific and Cultural Organization (UNESCO) and the United
Nations High Commissioner for Refugees (UNHCR). The inter-agency team
participating in the preparation of this paper included: Christopher Castle,
Alexandra Draxler, Andrea Miller, Olivier Nay, Mary Joy Pigozzi, Mark Richmond,
Justine Sass, Marian Schilperoord, Paul Spiegel and Joan Sullivan-Owomoyela.

UNESCO and UNHCR would also like to thank Eva Ahlen, Laurie Bruns, Marion
Fresia, Nathalie Meynet and Christopher Talbot, who provided useful comments
and suggestions on earlier versions of this publication. Appreciation is also
offered to the Inter-Agency Network for Education in Emergencies (INEE) for
the use of the Minimum Standards for Education in Emergencies, Chronic Crises
and Early Reconstruction for the purpose of this paper.

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ACRONYMS

AIDS Acquired Immune Deficiency Syndrome


ART Antiretroviral Therapy
BCC Behaviour Change Communication
EFA Education for All
DRC Democratic Republic of the Congo
GCE Global Campaign for Education
GIPA Greater Involvement of People living with HIV and AIDS
HIV Human Immunodeficiency Virus
IASC Inter-Agency Standing Committee
IDP Internally Displaced Person
IEC Information, Education and Communication
INEE Inter-Agency Network for Education in Emergencies
IRC International Rescue Committee
LSPS Live Safe, Play Safe
M&E Monitoring and Evaluation
MSEE Minimum Standards for Education in Emergencies,
Chronic Crises and Early Reconstruction
PRSP Poverty Reduction Strategy Paper
PTA Parent-Teacher-Association
STI Sexually Transmitted Infection
UNAIDS United Nations Joint Programme on HIV/AIDS
UNESCO United Nations Educational, Scientific and Cultural Organization
UNHCR United Nations High Commissioner for Refugees
VCT Voluntary Counselling and Testing

5
OVERVIEW

6
T
his discussion paper, prepared by the United Nations
Educational, Scientific and Cultural Organization (UNESCO)
and the United Nations High Commissioner for Refugees
(UNHCR), is intended for policy-makers and implementers in
ministries of education, civil society organizations, and donor and
development agencies involved in emergency, reconstruction and
development responses.

It examines the current situation with regard to conflict, dis- The analysis and recommendations offered in this paper are
placement and HIV, and notes the protection risks faced by based on the:
refugees and Internally Displaced Persons (IDPs). It recognises • Long programmatic experience of UNHCR in safeguar-
the importance of education for affected populations, and re- ding the rights and well-being of refugee populations;
fers to the existing and significant work undertaken to develop • Conceptual framework1 of EDUCAIDS, the UNAIDS
minimum standards for education in emergency situations. Global Initiative on Education and HIV & AIDS, led by
The paper then focuses on the key components of education UNESCO. A multi-country initiative, EDUCAIDS supports
sector responses to HIV and AIDS, and addresses the policy the implementation of comprehensive national educa-
and programmatic measures required to address the preven- tion sector responses to the HIV and AIDS epidemic;
tion, treatment, care and support needs of refugees and IDPs and
as well as the HIV-related stigma and discrimination that they • Application of the Minimum Standards for Education
often face. The paper concludes with a number of recommen- in Emergencies, Chronic Crises and Early Reconstruction
dations, including a call to ministries of education, civil society (MSEE), developed by the Inter-Agency Network for
organizations, and their development partners to: Education in Emergencies (INEE) and the Guidelines for
• Coordinate HIV and AIDS education for refugees and HIV/AIDS Interventions in Emergency Settings, developed
IDPs with other educational initiatives at the country, by the Inter-Agency Standing Committee (IASC) to
sub-national and organizational levels in order to avoid orient the educational response to HIV and AIDS.
duplication of efforts and to maximise the effective use
of human, financial and material resources. As further programmatic and policy experience emerge,
• Promote the principles put forward in the Dakar Frame- UNESCO and UNHCR envisage the production of additional
work for Action, including the achievement of the six guidance and support materials for the formulation and im-
Education for All (EFA) goals by 2015. plementation of comprehensive educational responses to HIV
• Meaningfully involve communities in programme and AIDS for refugees and IDPs. As such, this paper should be
development, implementation, monitoring and evalu- considered the first of a series of technical materials aimed at
ation. supporting responses for these populations.
• Scale up and make programmes more comprehensive
over time and across displacement phases.
• Customise the message in consultation with the
community.
• Monitor and evaluate programmes to guide future
actions and take corrective measures when needed.

7
CURRENT SITUATION
OF REFUGEES AND IDPS

In 2005, more than 44 million people, primarily in low-income The emergency phase, associated with the onset of conflict or
countries, were forcibly displaced by conflict, violence, crisis or some other emergency leading to the flight of those affected,
persecution due to race, religion, nationality, political opinion or is generally one of extreme hardship, including a destabilisation
membership of a particular social group.2 In an encouraging trend, of cultural bases, collapse of traditional community structures,
the number of refugees – people who have fled persecution in separation of children and youth from their families, destruction
their own countries to seek safety in neighbouring states – has of basic health and education services, and socio-economic dis-
fallen in recent years.3 In contrast, the number of IDPs – people ruption. The people involved face material, physical, and psycho-
who have been forced or obliged to flee their homes or places of logical loss both directly from the events and indirectly from the
habitual residence and who have not crossed an internally recog- cumulative effect of their increased vulnerability. They can find
nized border – continues to rise as states have closed their borders themselves in situations of tension in their new surroundings
to refugees or adopted restrictive admission policies.4 Moreover, both within refugee groups and with the population of the host
the stay of displaced populations in their new locations is often country.
for very long period of time. For refugees, the average estimated
length of stay increased from nine years in 1993 to seventeen The post-emergency or stabilisation phase is generally
years by the end of 2003, with children spending on average marked by greater stability, during which humanitarian
approximately eight years.5 assistance generally delivers the most basic necessities and
social services. During this phase, external assistance is also
Each crisis, and each phase of each crisis, has its own unique aiming to prepare refugees or IDPs for return, repatriation, local
characteristics and complexity, demanding a careful, sensitive integration or resettlement.
analysis before formulating interventions. Refugees typically
face a cycle of displacement (see Figure 1) whereby they suffer During the final durable solutions phase, refugees are able to
through an emergency, live through a period of relative stability return home, integrate into the host country or resettle to a third
in a post-emergency situation, and then experience another cycle country or integrate into the population of their host country.6
of readjustment when they are faced with durable solutions of The risks during the third phase are context-specific, complex and
repatriation, settlement in the host country, or resettlement to a vary from location to location.
third country.

Figure 1: Refugee Cycle of Displacement


0OST%MERGENCY
Source: UNAIDS and UNHCR.
Strategies to Support 2EFUGEES
the HIV-related Needs of
Refugees and Host Populations. (/34#/5.429
Geneva, 2005.
2ESETTLEMENT )NTEGRATION %MERGENCY
0REPAREDNESS

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2EPATRIATION #/5.429/&/2)'). )$0S


.ON DISPLACED
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8
CONFLICT, DISPLACEMENT
AND HIV

It is a common misconception that refugees pose an AIDS reduces access to HIV prevention commodities, information
threat to host communities.7 Data indicate that refugees often and HIV-related treatment and care during conflict and flight.
migrate from countries in conflict with lower HIV prevalence
to more stable host countries with higher HIV prevalence.8 Factors that can limit the transmission of HIV among refugees
Myths about overall high HIV prevalence levels among refu- are less well-studied, but may include: reduced mobility to
gees compound the stigma that refugees already face, further high prevalence urban areas in search of work; the isolation
constraining their access to health services and highlighting and inaccessibility of some refugee populations; and in some
the need to address HIV-related stigma circumstances, especially in the post-
and discrimination as an integral part The many factors that contribute to emergency phase, the availability of
of effective responses. the increased HIV risks to refugees better protection and other HIV-related
services than in countries of origin or
The many factors that contribute to in emergency and post-emergency among surrounding populations.11
the increased HIV risks to refugees phases are well-understood. They
in emergency and post-emergency The HIV risks to host communities are
phases are well-understood.9 They
include loss of livelihoods and lack not yet fully understood and depend
include loss of livelihoods and lack of access to basic services, often on the comparative HIV prevalence
of access to basic services, often in- increasing the vulnerability of women and on the extent of interactions
creasing the vulnerability of women between refugee and host commu-
and girls to sexual exploitation.10 Also, and girls to sexual exploitation. nity populations. However, trends are
conflict increases sexual violence becoming apparent: the majority of
against women and girls, including rape as a weapon of war, refugees live within host communities, not in camps12 and
and breaks down social networks and institutions that usually they often stay for years in their host countries and live in close
provide support and regulate behaviour. Exposure to mass contact with surrounding communities. Failure to address the
trauma such as conflict can increase alcohol and other drug HIV-related needs of refugees not only denies refugees their
use and, in general, influence people’s attitudes towards risk. rights, but undermines the effectiveness of HIV prevention
The additional disruption to health and education services and care efforts for surrounding communities.

9
SPECIAL CHARACTERISTICS
AND PROTECTION RISKS
OF REFUGEES AND IDPS

D
eveloping interventions to prevent HIV transmission and
provide protection and services to those affected by AIDS
in a situation of institutional breakdown poses particular
challenges. For example, both the general socio-economic situation
of refugees and the specific provision of formal and non-formal
education are often quite different from elsewhere. Life in refugee
situations differs in the nature of the populations, the settings and
the phase of emergency, but they typically share some common
characteristics:

10
Poverty and dependency on aid compounded difficulties in access to education, may marry
younger, be exposed to sexual exploitation (including in the
Refugees are often housed in camps in remote areas. With education environment), suffer from stigma, and are often the
little or no access to jobs or land to farm, the combination of last to receive medical treatment.
poverty, idleness and hopelessness brings forth a host of new
problem behaviours: increased domestic violence, survival sex Special attention must also be paid to children affected by HIV,
and early marriage. These are exacerbated by the absence of including those orphaned or made otherwise vulnerable by
social structures that normally serve to support individuals AIDS. A UNICEF study (2001) found that “of the 17 countries
and groups in difficulty and are broken down during conflict with over 100,000 children orphaned by AIDS, 13 are in conflict
and flight. Limited financial opportunities can also lead to or on the brink of emergency involving conflict”. For example,
dependency on international humanitarian assistance inclu- in the Democratic Republic of the Congo (DRC), only now
ding food and other material support. emerging from a long history of war, some 680,000 children
have lost their parents to AIDS.16
In protracted situations, many IDPs remain in difficult condi-
tions due to limited access to humanitarian assistance. Often The situation for urban refugees and IDPs can often be worse
facing the same problems and in similar circumstances as than that of refugees living in camps. Often dispersed, diverse
refugees, IDPs may not have recourse to material support such and difficult to reach,17 they have little or no access to social
as seeds, tools and other implementing devices offered to and medical services, including formal education opportuni-
returning refugees.13 ties and HIV prevention, treatment and care programmes. They
are often unaware of available local services, or of their right to
access these services. They are among the first victims of a va-

A buse and trauma riety of discriminatory and xenophobic attitudes. For example,
host communities and local service providers may view urban
refugees as responsible for crime, economic competition or
Human rights violations including sexual exploitation, torture, the spread of disease. As these attitudes may also be present
abandonment, forced recruitment into militia and armed in local schools hosting refugee learners, it is imperative that
forces, and abduction and trafficking can lead to physical, education on refugee rights, including rights related to HIV and
mental and emotional trauma.14 Moreover, these violations are AIDS, be incorporated in school curricula and teacher training
often cyclical, with a history of repetition throughout all phases in urban settings.
of displacement. Refugee and IDPs may feel too vulnerable and
traumatised to attend educational programmes because of their
experiences, and girl students and their families in particular
may have heightened concerns about their safety, which – if not
addressed – can force students to remain at home.
O bstacles to schooling and learning
Education systems are often destroyed in conflict situations.
During the Mozambique conflict in the 1980s-1990s, for

C ompounded protection risks example, 45 percent of schools were destroyed.18 Many refugee
and internally displaced children lose their chance of getting
an education. In Colombia in 2000, an estimated 85 percent of
Women often face a double-risk of contracting HIV, due to bio- children in camps were believed to not be receiving a primary
logical, social, and economic vulnerability and vulnerabilities education.19
caused by conflict situations. Increased rape during conflict
and displacement heightens the risk of transmission of sexual- While IDPs may have access to the formal education system,
ly transmitted infections (STIs), including HIV. Female refugees refugees seldom have the same access either because they
may find themselves separated from family members or tradi- do not have the proper documentation (e.g., birth registra-
tional support mechanisms, isolated from their communities tion documents) for enrolment, are unable to pay school fees
and confronted with new challenges, such as providing for and related costs, or do not have sufficient fluency in the
themselves and their children in situations of particular hard- medium of instruction. Where educational opportunities are
ship, as well as new forms of violence and risks in the country available to refugees (and may, in some cases, be superior
of refuge.15 to what is available to the local population), secondary and
higher education opportunities are typically severely limited.
Similarly, girls are hit harder and younger than boys by the Thus, in refugee situations as elsewhere, formal HIV and AIDS
epidemic in general. For girl refugees and IDPs, many fac- education may not reach all target populations, including vul-
tors of vulnerability become much greater: girls prematurely nerable groups such as out-of-school youth, and non-formal
take on heads-of-household and other responsibilities, have programmes are required to fill the gap.

11
EDUCATION FOR
REFUGEES AND IDPS

W
hile governments and international organizations view
food, water, shelter and health care as basic necessities
during emergencies, education does not always have a
similar level of support, particularly in the emergency phase of the
cycle of displacement. However, there are numerous reasons why
formal education (e.g., school-based) and non-formal education
(e.g., out-of-school) are important for refugees and IDPs, in particular
children and young people. In addition to providing the essential
building blocks for learning, education in emergencies can protect
against exploitation and harm; offer structure, stability and hope in
a time of crisis; promote the acquisition of skills for life; and support
conflict resolution and peace building.20

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The right to education for all calamities and instability” as well as to create “educational
programmes and actions to combat the HIV/AIDS pan-
demic”.21 Education on HIV is also recognised by UNHCR as a
Education has been recognised by numerous international critical service in its 2006 Note on HIV/AIDS and the Protection
conventions, declarations and commitments (see Box 1) as a of Refugees, IDPs, and Other Persons of Concern. Here, UNHCR
fundamental human right, key to sustainable development indicates that “the right to health includes access not only
and peace and stability within and among countries. to HIV treatment, but also to HIV-related education” and that
“States and UNHCR should ensure the widespread provision
Commitments made by the international community to of information about HIV and AIDS to refugees, IDPs and
the achievement of EFA include a specific pledge to “meet other persons of concern”.22
the needs of education systems affected by conflict, natural

Commitments made by the international community to the achievement of EFA


include a specific pledge to “meet the needs of education systems affected by conflict,
natural calamities and instability” as well as to create “educational programmes and
actions to combat the HIV/AIDS pandemic”.

In t e r n a t i o n a l C o n v e n t i o n s , D e c l a r a t i o n s
and Commitments Supporting Education
Box 1
• 1948 Universal Declaration of Human Rights, Article 26, states that “everyone has the right to an
education”.
• 1949 Fourth Geneva Convention Relative to the Protection of Civilian Persons during Times of War,
Article 50, states that “the Occupying Power shall, with the cooperation of the national and local authori-
ties, facilitate the proper working of all institutions devoted to the care and education of children”.
• 1951 Convention Relating to the Status of Refugees, Article 22, declares States shall accord to
refugees “the same treatment as…nationals with respect to elementary education”.
• 1966 International Covenant on Economic, Social, and Cultural Rights, Article 2, enshrines the
right to education “without discrimination of any kind as to race, colour, sex, language, religion,
political or other opinion, national or social origin, property, birth or other status”.
• 1989 Convention on Rights of the Child reaffirms the right of children to free, relevant and quality
education regardless of status.
• 2000 Dakar Framework for Action: Education for All states that signatories should “implement as a
matter of urgency education programmes and actions to combat the HIV/AIDS pandemic”.
• Millennium Development Goals (MDGs) include two goals directly related to education: Goal 2
“Ensure that all boys and girls complete a full course of primary schooling;” and Goal 3 “Eliminate
gender disparity in primary and secondary education preferably by 2005, and at all levels by 2015”.

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E ducation for girls and women demands, or low expectations of families keep girls from school.
In other situations, refugee and IDP camps achieve increased
participation of girls in schooling due to the proximity of
In emergency situations as everywhere else, attention to equal learning institutions or structured incentives within the camp
access to education for women and girls is paramount. There setting.27
is compelling evidence that more highly educated girls and
women are better able to delay sexual debut and negotiate UNHCR encourages the implementation of special initiatives to
safer sex. A recent analysis of eight sub-Saharan countries support and increase the retention of refugee girls and young
showed that women with eight or more years of schooling women in educational programmes. These include:
were 47 to 87 percent less likely to have sex before the age • Provision of uniforms and/or clothes;
of 18 than women with no schooling.23 There is also evidence • Development of safe and gender-friendly learning envi-
that education affects young women’s choices regarding the ronments, including separate latrines for girls and boys
use of condoms or abstaining from high-risk sex. Surveys in 22 and the provision of sanitary materials;
countries show a correlation between higher education levels • Development and enforcement of a code of conduct
and more condom use.24 In the DRC, Rwanda, Tanzania and for educational staff and students;
Uganda, more educated girls and women have been found to • Use of separate classrooms for girls and boys, if culturally
have lower levels of HIV infection.25 Furthermore, higher levels appropriate;
of education among women are closely associated with lower • Recruitment of trained teachers from refugee commu-
infant and under-five mortality rates. Better-educated women nities and of female teachers (UNHCR recommends that
are more likely than less-educated women to understand the at least 50 percent of all teachers be female in refugee
importance of antenatal care, hygienic child care practices and situations);
good nutrition for themselves and their children. They are also • Training of teachers on gender issues, including sexual
more likely to know where to access health care and to be able and gender-based violence;
to afford such care.26 • Facilitation of accessible and confidential access to
health and community services, including psychosocial
Emergency situations can change the gender balance in support; and
classrooms, with varying consequences. Sometimes insecure • Provision of training and income-generating opportu-
routes, endemic violence, household, chores and care-giving nities.

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Q uality education in emergency The Standards are designed for use in emergency response,
emergency preparedness and humanitarian advocacy and
settings are applicable in a wide range of situations, including natural
disasters and armed conflicts. They provide guidance and flex-
There has been intensive cooperation among humanitarian ibility in responding to needs at the most important level –
organizations to develop minimum standards for education in the community – while providing a harmonised framework to
emergency situations, chronic crisis and early recovery. These coordinate the educational activities of national governments,
are intended “help achieve a minimum level of educational other authorities, funding agencies, and national and interna-
access and quality in emergencies and early reconstruction as tional agencies”.29
well as to ensure the accountability of the workers who provide
these services”.28 These Standards are a useful departure point for the develop-
ment of educational responses to HIV and AIDS as they address
INEE’s Working Group on Minimum Standards for Educa- the policy principles, strategic actions, and coordination mech-
tion in Emergencies, Chronic Crises and Early Reconstruction anisms required for education in emergencies. The following
facilitated a highly consultative process to develop the section builds on the standards and indicators presented in the
Minimum Standards for Education in Emergencies, Chronic Crises INEE Minimum Standards for Education in Emergencies, Chronic
and Early Reconstruction. The INEE Minimum Standards were Crises and Early Reconstruction, and the strategies and priori-
developed with the participation of over 2,250 individuals from ties set forth in the Inter-Agency Standing Committee (IASC)
more than 50 countries in 2003 and 2004. Guidelines for HIV/AIDS Interventions in Emergency Settings to
present a framework for educational responses to HIV and AIDS.

15
KEY COMPONENTS OF
EDUCATIONAL RESPONSES
TO HIV AND AIDS
FOR REFUGEES AND IDPS

...UNESCO and UNHCR recognise that every emergency situation is


different, and each programme may be at a different starting point.
Staged and scaled-up implementation is necessary to prepare individuals
and communities to move from a dire situation to one in which they are in
charge and for which they have skills, attitudes and health for success.

16
D
uring the period of displacement – from the onset of a
complex emergency to the moment a durable solution is
found – refugees are often excluded from host countries’
strategies, policies and programmes on HIV and AIDS, and their needs
are generally not addressed in proposals submitted to or funded by
major donors.30 This may undermine effective HIV prevention and
AIDS mitigation efforts for both refugees/IDPs and surrounding
populations.

It is critical that efforts be made to ensure that refugees and IDPs,


particularly children and young people, have access to educational
opportunities as education provides the knowledge and skills
essential for the prevention of HIV, and protects individuals, families,
and communities from the impact of AIDS. Education also helps
to overcome the conditions that facilitate the spread of HIV, and
can create the conditions of understanding and tolerance that
contribute to reduced stigma and discrimination against people
living with HIV.31

UNESCO and UNHCR recommend staged and scaled-up in- components, providing examples of policy and programmatic
terventions that address the prevention, treatment, care and measures to be undertaken by ministries of education, civil
support needs of refugees and IDPs as well as the HIV-related society organizations and their development partners.
stigma and discrimination that they often face. To be effective,
interventions need to use all educational modalities (formal, A comprehensive response is critical – all of these five compo-
non-formal and informal32) and ensure multisectoral approaches nents need to be in place and working well to ensure optimal
to address the epidemic in an effective and efficient way. success in the response to the epidemic among refugees and
IDPs. At the same time, UNESCO and UNHCR recognise that
A comprehensive educational responses to HIV and AIDS for every emergency situation is different, and each programme
refugees and IDPs is comprised of five essential components: may be at a different starting point. Staged and scaled-up imple-
1) policy, management and systems; 2) quality education (in- mentation is necessary to prepare individuals and communities
cluding cross-cutting principles); 3) content, curriculum and to move from a dire situation to one in which they are in charge
learning materials; 4) educator training and support; and 5) ap- and for which they have skills, attitudes and health for success.
proaches and entry points. This section addresses each of these

17
1 Policy, management and systems coordination and information sharing between stakeholders.
For example, local networks/committees (e.g., refugee camp
education committees) can act as a bridge between refugees
A crucial lesson learned by UNESCO and UNHCR is the need to and policy-makers for HIV and AIDS education issues. Educa-
ensure that HIV and AIDS policies and interventions for refugees tion and HIV and AIDS Focal Points in emergency settings can
and IDPs are coordinated, mainstreamed and integrated also liaise with other national agencies conducting HIV and
with those at country and organizational levels to maximise AIDS activities to support synergies and linkages.
resources and services. For example, the needs of refugees
and IDPs should be an element of national education sector Combining resources given for refugees with host country
policies on HIV and AIDS in affected countries (see Box 2), resources can provide additional support for the building and
budgeted and integrated into regular government plans and operation of primary and secondary schools, especially in rural
financial mechanisms. areas. In areas where there are few schools, combining donor
resources and host country resources for school construction
National legal frameworks and policies including those that can offer increased access to educational opportunities for
promote compulsory education and free schooling should also refugees and host country nationals alike.
be applicable to educational programmes for displaced popu-
lations. If it is not possible or practical for refugees to attend The development of policies and plans is most effective when
host country schools, separate educational programmes need based on timely assessments undertaken in wide consultation
to be established in refugee camps. UNESCO and UNHCR sup- with affected populations and consideration of previous
port the application of the Minimum Standards for Education in experience, policies and practices of affected populations. For
Emergencies, Chronic Crises and Early Reconstruction which state the establishment of educational programmes in emergency
that “as part of the emergency response, education authorities settings, the INEE recommends that “a timely education
and key stakeholders should develop and implement an edu- assessment of the emergency situation [be] conducted in a
cation plan that takes into account national and international holistic and participatory manner” and that this assessment be
educational policies, upholds the right to education, and is used to develop a framework “including a clear description of
responsive to the learning needs of affected populations”.33 the problem and a documented strategy for the response”.34 To
be sure that HIV and AIDS are adequately addressed, UNESCO
Similarly, interventions in emergency settings should also and UNHCR support the incorporation of HIV and AIDS
figure, wherever possible, in national AIDS strategies and in indicators in the situation analysis or baseline assessment and
broader development frameworks and mechanisms, such as ongoing monitoring and evaluation of educational responses
poverty reduction strategy papers (PRSPs). Education networks/ (examples of qualitative and quantitative measurements by
working groups can be a consultative vehicle to incorporate HIV population group can be found in Box 3). All data should be
and AIDS education into host country AIDS plans by supporting disaggregated by sex and age, wherever possible.

Ma i n s t r e a m i n g t h e N e e d s o f R e f u g e e s a n d I D P s i n
the Education Sector Policy on HIV/AIDS, Uganda
Box 2
As one of the principles underlying the policy, “the In terms of the management of the education sec-
large numbers of people affected and displaced by tor response to HIV/AIDS, “all education sector in-
conflict, disaster and other emergencies is a matter stitutions involved in the planning, programming
of high priority in terms of HIV/AIDS response and and delivery of HIV/AIDS related interventions
requires the special provision of education”. will take special measures in areas of conflict and
in the case of displaced populations. Basic assis-
With regard to treatment, care, support and impact tance and treatment and care will receive priority
mitigation, “education sector institutions shall where children and adults are at risk of poverty,
work with existing national and local programmes abduction and abuse”.
to monitor and address the risks faced by learners
whose safety is put at risk by armed conflict, inter- Source: Ministry of Education and Sports, the Republic of
nal displacement, refugee status and abduction”. Uganda 2005

18
Se l e c t e d H I V- a n d A I D S - r e l a t e d I n d i c a t o r s f o r
Educational Planning, by Population Group
Box 3
Learners • Sources of information about sexuality, reproductive health and HIV
• Knowledge of HIV prevention methods
• Median age at first sex
• Relationships: expectations; attitudes to sex; transactional sex; forced sex; age mixing
• Attitudes toward people living with HIV
• Learners’ preferred sex of the educator teaching about HIV and AIDS
Educators • Knowledge of HIV and AIDS
• Attitudes toward people living with HIV, including toward involving people living with HIV
in the learning environment
• Attitudes toward community involvement in the learning environment
• Training in HIV and AIDS (including pre- and in-service training)
• Comfort with and experience of teaching on sexuality, reproductive health and HIV
• Extent willing to address HIV and AIDS in curriculum
Community • Extent to which leaders and other key groups (e.g., women and youth) are included
Members in the HIV curriculum development process
• Availability of condoms and other commodities; availability and use of HIV testing services
• Attitudes toward HIV and AIDS education
• Attitudes toward people living with HIV, including toward involving people living with HIV
in the learning environment

2 Q uality education, including to address the needs at the level of the learner and at the level
of the learning system. For example, at the level of the learner,
cross-cutting principles education systems must acknowledge what the learner brings
to the learning environment. In refugee situations, this may
Access to a good quality education on its own, apart from include a certain sense of hopelessness and fatalism among
anything else, is widely recognised as an effective means of students and communities, requiring that education be attrac-
reducing the vulnerability of learners to HIV and AIDS. Education tive to engage learners and maintain their interest. At the level
must be rights-based, proactive and inclusive, with curricula of the learning system, this may require expanded efforts to
and instructional approaches that are gender-sensitive, scien- measure learning outcomes to measure not only knowledge,
tifically accurate and culturally appropriate. Effective learning is but also skills or competencies such as problem-solving, values
critical, requiring educational programmes to support reforms such as tolerance and gender equality, and behaviours. 35

19
To ensure the quality of formal and non-formal educational mote the protection and mental and emotional well-being of
services and programmes, the INEE minimum standards call learners”.37 This includes working with education personnel and
for the active participation of emergency-affected community community members to ensure:
members in programme assessment, planning, implemen- • Safe and secure access to educational facilities;
tation, and monitoring and evaluation.36 “Community edu- • Appropriate physical structure for the learning site,
cation committees,” comprised of parents and/or members of including adequate space, recreation and sanitation
parent-teacher-associations (PTAs), local agencies, civil society facilities (e.g., water for personal hygiene and clean
associations, community organizations, youth and women’s latrines or toilets for males and females);
groups, and teachers and learners, can be key resources in • Zero tolerance policies for violence in learning places,
many settings to prioritise and plan educational activities include codes of conduct prohibiting sexual relation-
and develop a community-based action plan. (See Box 4 for ships between learners and educators; and
selected activities to support community participation in HIV • Linkages with health, nutrition and other social services in
and AIDS educational programmes). the vicinity to support the overall well-being of learners.
This may include sports and recreation, social clubs and
Efforts should also be put in place to ensure the INEE minimum the promotion of mutual support networks.
standard that “learning environments are secure, and pro-

S e l e c t e d Ac t i v i t i e s t o S u p p o r t Co m m u n i t y Pa r t i c i p a t i o n
i n H I V a n d A I D S E d u c a t i o n a l P r o g ra m m e s
Box 4
• Promote displaced and surrounding commu- • Work with displaced and surrounding com-
nity involvement in the situation analysis, and munity education committees to support
the planning, implementation, and evaluation community involvement in the educational
of educational activities environment e.g., the establishment and
• Educate displaced and surrounding commu- monitoring of a Code of Conduct
nity education committee members about • Promote the involvement of people living
HIV and AIDS including HIV transmission, risk, with HIV from both displaced and surrounding
vulnerability, treatment, care and rights communities in educational activities

20
Curriculum Considerations for HIV and AIDS Education
1. Define curricular approach: • Addressing gender issues (gender and culture,
Box 5
• Stand alone subject e.g., HIV and AIDS educa- vulnerability, local culture)
tion clearly labelled and earmarked in the edu- • Promoting human rights and overcoming
cational programme stigma and discrimination (rights and physical
• One main carrier subject e.g., HIV and AIDS ad- integrity, impact of AIDS and care for people
dressed within the framework of one main affected by HIV, overcoming silence)
subject such as Natural Sciences, Physical and
Health Education, and Social Studies 3. Consider time allocation for each lesson or
• Cross-curricular e.g., HIV and AIDS is addressed unit and teaching-learning objectives and
in a few subjects through a complementary outcomes
and coordinated approach
• Infused e.g., HIV and AIDS integrated in most/all 4. Determine pedagogical approach and
subjects in the curriculum with or without any teaching methods and implications for
specific mention of HIV and AIDS in the subject teacher training and support
areas
5. Use, adapt, or develop instructional mate-
2. Establish core content of curriculum, e.g.: rials in line with the needs and characteristics
• Basic knowledge (sexual and reproductive of the learner
health, HIV and AIDS, treatment and care,
myths and misperceptions)
• Me, my emotions and others (respecting my-
self and others, coping with difficult and risky
situations, coping with loss) Source: UNESCO/IBE 2006

3 C ontent, curriculum and participation of stakeholders (see also Quality education,


including cross-cutting principles).
learning materials
The refugees’ length of stay in a host country may further
The development of content, curriculum and training ma- impact curriculum development. In emergency settings, cur-
terials for HIV and AIDS education must consider the age or ricula are often adapted from either the host country, the
developmental level, language, culture, capacities and needs country of origin or other emergency settings. In Tanzania,
of learners and include not only prevention knowledge, at- for example, UNHCR and UNICEF supported the introduction
titudes and behaviours but also issues related to treatment, of the HIV curriculum used in the Burundian schools in the
care and support as well as stigma and discrimination. It Tanzanian refugee camp schools for this population.
should also follow the INEE Minimum Standard of being “cul-
turally, socially and linguistically relevant…[and] appropriate UNHCR recommends that, in longer-term refugee situations,
to the particular emergency situation”.38 programmes “face both ways” to be acceptable in both the
country of origin and the host country. When the language
Where curriculum development or adaptation is required, of instruction is the same for refugees and host communities,
there are a number of important considerations including refugees may follow the host country curriculum since
the curricular approach, core content, teaching and learning this allows access to national leaving certificates, enabling
objectives and outcomes, pedagogical approach and instruc- refugees to continue to access learning opportunities after
tional materials (see Box 5 above). Wherever possible, curricu- the emergency.
lum development should be conducted with the meaningful

21
Educational programmes must also consider and address or repatriation. Educational programmes (including formal,
the psychosocial needs and development of learners and non-formal and informal education) should not only aim to
educators at all stages of the displacement cycle, including transfer information, but develop skills to help learners make
during the crisis and in preparation for integration, settle- informed decisions about behaviours and relationships. (see
ment in the host country, resettlement in a third country, Boxes 6 and 7).

Ps y c h o - s o c i a l S u p p o r t
through “Community Conversations”
Box 6
In the Republic of Congo, UNHCR has undertaken increased openness of men and women to explore
“Community Conversations” to offer space for dia- and address difficult and sensitive issues related
logue, mutual learning, reflection and introspec- to HIV and AIDS; increased demand for informa-
tion on HIV. Between December 2004 and March tion on HIV and AIDS; and increased demand for
2005, 92 “Conversations” were held. UNHCR re- condoms.
ports initial signs of behaviour change including: Source: UNHCR 2005a

HI V P r e v e n t i o n R e c r e a t i o n a l A c t i v i t i e s
f o r R e f u g e e C h i l d r e n a n d Yo u t h
Box 7
Right to Play, formerly known as Olympic Aid, has ted in the camps to raise awareness and build
developed and supported sports and games in skills to prevent HIV infection among young
refugee camps in a number of African countries people. LSPS uses physical activities, group work,
including Angola, Benin, Ethiopia, Ghana, Guinea, role-playing and active discussions to engage
Kenya, Mali, Mozambique, Rwanda, Sierra Leone, children and youth to build skills in: negotiation;
Tanzania, Uganda and Zambia. The camps aim assertiveness; coping with peer pressure; and
feeling compassion for those living with HIV.
to support young refugees to have fun with a
Programme modules include: facts about HIV
purpose.
and AIDS, preventing HIV infection, values and
vulnerability, communication and compassion.
Live Safe, Play Safe (LSPS) is a skills-based health
education programme that has been implemen- Source: UNHCR 2003c

22
4 E ducator training and support teacher selection and promotion criteria do not discriminate
or stigmatise teachers and other educational programme staff
infected or affected by HIV.
In order to address HIV and AIDS in their own lives and in the
lives of those they instruct and mentor, educators must be In rural areas, where some refugee camps are located, local host
provided with appropriate HIV-related knowledge, skills and communities have a limited resource pool to draw from to staff
resources, and be supported by institutions and communities. a school. Typically, educational programmes use an international
This includes both pre-service training and continuing profes- lingua franca (e.g., Arabic, English, French and Spanish) as the me-
sional development programmes for teachers in school set- dium of instruction in the upper primary and secondary grades.
tings and relevant training for non-formal educators, including When there is a compatible lingua franca, teachers may be sought
peer educators, community and religious leaders, and tradi- from among the refugee community for HIV education for both
tional healers involved in HIV and AIDS education. the displaced and host community populations. Community
members living with HIV can also be powerful educators, serving
For formal educational programmes, the INEE Minimum Standards as role models, reducing stigma surrounding HIV and AIDS, and
support the recruitment of “appropriately qualified teachers providing personal benefits to those involved. However, the in-
and other education personnel” through “a participatory and volvement of people with HIV must be carried out in a planned,
transparent process based on selection criteria that reflect sensitive and responsible manner to avoid being tokenistic or
diversity and equity”.39 Efforts must also be taken to ensure that exposing them to further stigma and discrimination.

23
The development of training curriculum and content for
educators should be based on their identified needs and
5 A pproaches and entry points
may include: core knowledge on HIV and AIDS, pedagogical
and teaching methodologies (including approaches for adult To ensure coverage and sustainability, educational programmes
learning or for learners with special needs), curriculum develop- should employ a range of approaches and entry points. These
ment, psychosocial support to understand trauma related to can include, for example, community-based learning and
displacement and promote healthy living, and information on outreach, school feeding and school health programmes,
conditions of work and codes of conduct. Provision should be behaviour change communication (BCC) and information-
made, wherever possible, for ongoing support, appropriate education-communication (IEC) programmes, adult education
follow-up, monitoring and supervision and refresher training, and literacy courses, and life skills education (see example in
as necessary. Box 9). Extra-curricular activities that integrate HIV messages
can also reinforce formal educational programmes, and can
Efforts should be made to ensure that the training and educa- promote dialogue and discussion in culturally appropriate fora
tion received by refugee teachers, peer educators and students (such as community theatre, music, dance performances, and
meet the standards of the home countries, and will be recog- sport). The development of women’s groups can also support
nised upon the refugees’ return. Where refugees return to their discussions of sensitive issues such as sexual and gender-based
home country, the arrival of trained teachers, peer educators violence, although it is important to ensure that these groups
and community outreach workers can be a critical asset to the protect confidentiality so that no further suffering is caused
host country, facilitating the introduction of important educa- and lives are not further endangered.40
tional programmes, including HIV education, in areas of return
(see Box 8).

S upporting Returning Refugees to Bring HIV Prevention


Messages to Southern Sudan
Box 8
The signing of the Comprehensive Peace Ac- they can assist those who stayed behind in the
cord between the Federal Government of Sudan south,” explains UNHCR spokesperson Emmanuel
and the Sudan People’s Liberation Movement in Nyabera, in the Kenyan capital of Nairobi. UNHCR
early 2005 has enabled hundreds of thousands hopes that as “tools of information,” refugees can
of IDPs and refugees to begin the journey home. provide education for their peers in southern
To equip refugees for their return to an area with Sudan and counter prevailing stigma and dis-
limited knowledge about HIV, UN agencies and crimination attitudes toward people infected and
NGOs are intensifying HIV awareness training on affected by the epidemic.
HIV prevention among returning refugees “not
only so they can help themselves, but also so that Source: Human Rights House Foundation 2006

24
H IV and AIDS Education for Children,
Youth, and Female Urban Refugees
Box 9
UNHCR’s implementing partner in Moscow, During a baseline survey, nearly two-thirds of
Magee Woman Care International, views HIV the programme participants demonstrated a
prevention as a priority for urban refugees, limited understanding of HIV and AIDS and a
especially those in high-risk groups, such as limited knowledge of HIV prevention methods.
women of childbearing age (15-49) and young In some instances, participants reported that this
people. In addition to their work providing was the first time they had heard about HIV and
primary and basic medical care to asylum-seekers AIDS. After the classes, surveys showed marked
and refugees in and around Moscow, Magee increases in HIV awareness among participants.
Woman Care International has developed an HIV Subsequent classes revealed possible changes in
and AIDS educational programme. This includes behaviour, with teenagers noting that were now
informational materials delivered during in-class more likely to actively discuss issues related to a
instruction and distributed during patient visits to healthy lifestyle.
the Magee centres. Materials cover the following
themes: HIV transmission, prevention, and the
risks associated with AIDS.

25
CONCLUSIONS AND
RECOMMENDATIONS

26
This paper brings together the arguments in favour of a com- • Scale up and make programmes more comprehen-
prehensive response to HIV and AIDS through education, to sive over time and across displacement phases.
address the unique needs of refugees and IDPs. It sets forth Educational programmes may begin with simple
some actions that contribute to the minimum standards for community-based activities. However, efforts should be
HIV and AIDS education in these situations. It can be used to made to develop more formal educational programmes
design, implement and advocate for a comprehensive HIV and as rapidly as possible, with appropriate materials and
AIDS educational initiative for refugees and IDPs. educators who have been selected from among the
displaced populations and have been adequately
UNESCO and UNHCR have learned a number of lessons which trained. Programmes must also be ongoing across dis-
can inform future educational responses to HIV and AIDS for placement phases. For example, during the emergency
refugees and IDPs. This includes the need for ministries of phase, refugees and IDPs must be informed of the
education, civil society organizations, and their development types of HIV-related informational and material services
partners to: (e.g., condoms and other key prevention commodities)
available and how to access them. Structured educa-
• Coordinate HIV and AIDS education for refugees and tional programmes addressing HIV and AIDS should
IDPs with other educational initiatives at the coun- be put in place during this and the post-emergency or
try, sub-country and organizational levels in order stabilisation phase, and efforts undertaken to consoli-
to avoid duplication of efforts and to maximise the date achievements and ensure a successful transition
efficacy of human, financial and material resources. for those returning home, resettling in another country
Surrounding populations should be included in refu- or integrating into the host country population.
gees’ and IDPs’ educational activities whenever feasible,
in order to maximise use of available financial, material, • Customise the message in consultation with the com-
and human resources. This sharing of resources helps to munity. Tailoring messages to the specific needs of a
improve overall capacity and strengthen relationships population is key to changing behaviour, attitudes and
between displaced persons and the host community. practices. Identified good practices and social change
Additionally, this strategy may help to increase HIV and programmes, including HIV and AIDS programming,
AIDS awareness and reduce the stigma and discrimi- involve messages specifically designed for the target
nation which refugees and IDPs often face. However, populations. Effective programming of HIV prevention
without adequate funding from both the international messages, care and support activities, and stigma and
donor community and host countries, increased access discrimination reduction strategies require messages to
to educational programmes, in particular formal edu- be customised to meet local needs and to take cultural
cational programmes, for both populations will remain and linguistic diversity into account.
inadequate.
• Monitor and evaluate programmes to guide future
• Promote the principles put forward in the Dakar actions and take corrective measures when needed.
Framework for Action, including the achievement of In emergency situations, monitoring and evaluation
Education for All (by 2015). The international commu- (M&E) can be viewed by overworked professionals
nity must strive to provide adequate and sustained sup- as an unnecessary distraction and a strain on limited
port to countries that host refugee and other displaced resources. It is vital to dispel doubts and to ensure
populations, to provide quality education in these situa- that M&E is undertaken to guide future action and
tions. In particular, greater emphasis must be placed on take corrective measures where needed. M&E systems
ensuring that refugee and IDP young people, especially supply a valuable baseline reference to measure
girls, have access to educational opportunities to stem the effectiveness of programmes, and thus serve as
the transmission of HIV. powerful advocacy tools for successful programmes.
They provide useful data which can assist in determining
• Meaningfully involve communities in programme the best way to spend limited resources in order to
development, implementation, monitoring and achieve the best possible results. This can be especially
evaluation. In emergency settings, building trust be- important when developing and implementing new
tween the various populations is essential. Educational programmes such as HIV and AIDS education. Data
programmes developed through consultation and con- collection can be difficult in emergency situations, but
sensus with the displaced and local host communities is nevertheless invaluable to guide programming and
have a better chance of success than those imported make interventions more effective.
and implemented directly. Consultation can take place
through a committee working with the education
providers to discuss how to carry out the programmes
and to address concerns about sensitive issues like
reproductive health, sexuality and HIV and AIDS.

27
END NOTES

1. UNESCO 2006a 26. AGI 2002


2. U.S. Committee for Refugees 2006. This includes: 12 million 27. Sinclair 2002
refugees and asylum seekers; 1.04 million new refugees; 28. INEE 2004
7.89 million refugees in camps for 5 years or more; 21 mil- 29. INEE 2004
lion internally displaced persons; and 2.1 million new inter- 30. Lubbers 2003
nally displaced persons. 31. UNESCO 2006
3. UNHCR 2005d 32. As explained in UNESCO 2005, ‘formal education’ is usually
4. UNHCR 2006c provided by an education or training institution, structured
5. UNHCR 2004b (in terms of learning objectives, learning time or learning
6. UNAIDS and UNHCR 2005 support) and leads to some sort of certification. ‘Non-for-
7. UNCHR. 2006b, Draft 8 September mal education’ includes learning activities typically or-
8. Spiegel 2004 ganised outside the formal education system. In different
9. UNAIDS 2004a and UNAIDS 2006 contexts, non-formal education covers educational activi-
10. See UNAIDS, UNHCR and WFP 2006 ties aimed at imparting adult literacy, basic education for
11. Hynes, Sheik, Wilson, and Spiegel 2002 out-of-school children and youth, life skills, work skills, and
12. UNHCR 2006c. Of the 20.8 million displaced persons of con- general culture. Such activities usually have clear learning
cern to the UNHCR at the end of 2005, the location was objectives, but vary in duration, in conferring certification
known for 14 million. Of these, 26 percent were located in for acquired learning, and in organisational structure. ‘Infor-
camps or centres, 18 percent were living in urban areas, and mal education’ is learning that takes place in daily life with-
56 percent were either dispersed in rural areas or living in out clearly stated objectives. The term refers to a lifelong
an unknown type of settlement. In Africa, almost half the process whereby every individual acquires attitudes, values,
people of concern to UNHCR are in camps, as compared to skills and knowledge from daily experiences and the edu-
less than a quarter in Asia. cative influences and resources in his/her environment e.g.,
13. Holtzman and Nezam 2004 family and neighbours, work and play, the marketplace, the
14. Machel 1996 library and the mass media.
15. UNHCR 2004a 33. INEE 2004
16. UNAIDS 2006 34. INEE 2004:21. See also See Appendix 2 (Planning in an
17. Hynes, Sheik, Wilson and Spiegel 2002 Emergency Situation Analysis Checklist) and Appendix 3
18. Save the Children 2002:18 (Information Gathering and Needs Assessment Question-
19. CIDA 2000 naire)
20. INEE 2004 35. UNAIDS IATT 2006a
21. The Dakar Framework Education For All: Meeting Our Col- 36. INEE 2004:14-19
lective Commitments. Dakar, Senegal, April 2000. 37. INEE 2004:45
22. UNHCR 2006d 38. INEE 2004:56
23. de Walque 2004 39. INEE 2004:66
24. UNICEF 2004 40. UNHCR 1999
25. ActionAid International 2006. See also UNAIDS IATT on Edu-
cation 2006a

28
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Policy on HIV/AIDS. Draft 2. Kampala, Uganda. Accessed online 20
UNHCR. 2003a. Education Field Guidelines. Geneva, UNHCR. Ac- September 2006 at: http://hivaidsclearinghouse.unesco.org
cessed online 10 May, 2006 at: http://www.unhcr.org/cgibin/
texis/vtx/home?page=protect&id=405027d34 Women’s Commission for Refugee Women and Children/Re-
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tion Kit. Accessed online 10 October 2006 at: www.unhcr.org/

31
PHOTOS:
Cover photos:
© 2004 David Snyder/CRS, Courtesy of Photoshare

Photos:
p. 6 ©UNHCR/J.Clark
p. 9 ©UNHCR/J. De la Mota
p. 10 ©UNHCR/S. Schulman
p. 12 ©UNHCR/Ann Burton
p. 14 ©UNHCR/H. Caux
p. 16 ©UNHCR/L. Taylor
p. 20 ©UNHCR/Caitlin Meredith
p. 22 ©UNHCR/Caitlin Meredith
p. 23 ©UNHCR/G.M.B Akash
p. 25 ©UNHCR/L. Taylor
p. 26 ©UNHCR/H. Caux

All rights reserved. This document may be freely reviewed, abstracted, reproduced or translated,
in part or in whole, but not for sale or for use in conjunction with commercial purposes. The
designations employed and the presentation of material throughout this document do not
imply the expression of any opinion whatsoever on the part of UNESCO or UNHCR concerning
the legal status of any country, territory, city or area or its authorities, or concerning its frontiers
or boundaries.

Published by:
UNESCO
Education Sector
Division for the Coordination of UN Priorities in Education
Section on HIV and AIDS
7, Place de Fontenoy
75352 – Paris 07 SP, France
Website: www.unesco.org/aids
Email: aids@unesco.org

© January 2007. United Nations Educational, Scientific and Cultural Organization (UNESCO)
and United Nations High Commissioner for Refugees (UNHCR)

Composed and printed by UNESCO


ED-2007/WS/1 REV - CLD 31149
This discussion paper, prepared by the United Nations Educational,
Scientific and Cultural Organization (UNESCO) and the United Nations
High Commissioner for Refugees (UNHCR), is intended for policy-makers
and implementers in ministries of education, civil society organizations,
and donor and development agencies involved in emergency, recon-
struction and development responses.

It examines the current situation with regard to conflict, displacement


and HIV, and notes the protection risks faced by refugees and internally
displaced persons. It recognises the importance of education for affected
populations, and refers to the existing and significant work undertaken
to develop minimum standards for education in emergency situations.
The paper then focuses on the key components of education sector
responses to HIV and AIDS, and addresses the policy and programmatic
measures required to address the prevention, treatment, care and
support needs of refugees and internally displaced persons as well as
the HIV-related stigma and discrimination that they often face.

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